Registration Form
complete the form below to join us for a free preview class!
CLASS SCHEDULE
beginning September 2nd
14-week semester
Ages
0-18m
Tuesdays
10:00 AM - 10:45 AM
Enrolling
Ages
18m-3y
Tuesdays
11:00 AM - 11:45 AM
FULL
Ages
18m-3y
Wednesdays
10:00 AM - 10:45 AM
Enrolling
Ages
0-18m
Wednesdays
11:00 AM - 11:45 AM
FULL
Class Preference
please choose the day/time of the class you would like to attend. we will do our best to accommodate all requests, however, we cannot accommodate requests for classes that are already full. Please note classes do not begin until 9/2.
choose 1
Tuesdays at 10am (Village/Foundations for ages 0-18m)
Wednesdays at 10am (Our Time/Level 2 for ages 18m-3y)
Please choose your preferred date:
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Month
-
Day
Year
Date
Student Information
Name
First Name
Last Name
Age at start of class
*
Gender
Male
Female
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Any information you'd like for us to know about your child?
allergies, medical conditions, special interests, etc?
Parent/Guardian Information
Parent/Guardian Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Relationship
Miscellaneous
How do you learn about this class?
Facebook
Instagram
Search Engine
Word of Mouth
The Garden Montessori
Other
Agreements
Kindermusik with Ellen & Friends is not responsible for any items missing, lost or stolen while attending a Kindermusik class or event. Per studio request, please leave all food & street shoes outside of the studio before attending class. Anyone attending class should be free of contagious illness or disease. If you or your child is experiencing any symptoms of contagious illness or disease (fever over 100* not related to teething, vomiting, diarrhea, rash or other symptoms of contagious disease or illness), we ask that you do not attend class in order to help prevent the spread of germs and keep other families healthy. Families should remain symptom-free for 24 hours after experiencing these symptoms before attending any Kindermusik classes. WAIVER AND RELEASE FROM LIABILITYBy this Waiver, I assume any risk, and take full responsibility and waive any claims of personal injury, illnes, death or loss or damage to personal property regarding me and my child(ren) associated with Graham & Keane, LLC DBA Kindermusik with Ellen, their officers, agents, or employees activities and events organized by Graham & Keane, LLC DBA Kindermusik with Ellen. I understand and confirm that by signing this WAIVER AND RELEASE I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law. I am 18 year of age or older and mentally competent to enter into this waiver.
Signature
Date Signed
-
Month
-
Day
Year
Date
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